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Were pleased to be joined on this occasion by secretary of health and human services, alex azar, and administrator of center for medicare and medicaid services, seema, thank you both. Thank you both. And thank you all for being here. I appreciate it. The unprecedented reforms were completing today are the direct result of the historic drug pricing executive orders i signed in july. Statutorily, we had to go through a very long process and we got it done. I was very proud to have gotten this done. We were pushing it very hard. As we did with the vaccines and other things. The first action will save american seniors billions of dollars by preventing middlemen, famous middlemen, they call them, from ripping off patients high Prescription Drug prices. Currently, there are high discounts in the price of prescription medicines, including rebates to Medicare Part d plans last year alone. Yet often, middlemen stop those discounts from going to the patients, which is what were interested in. Not the middlemen. Who need it the most. So the patients will be getting the benefit instead of these very wealthy individuals. Patients pay very high prices and they have for many years. Although, we brought it down. First time in 51 years. With the costs adding up to hundreds or even thousands of dollars per year per patient. Todays action ends this injustice and requires that these discounts go directly to people. These are the people that need it. This will save patients up to 30 , could be 40 , could be 50 , could be much higher than that. These are numbers that nobodys ever even contemplated. That doesnt include lifesaving drugs like insulin, which will be even higher. Insulin was destroying lives and destroying families because the cost was so high. And now, its at a level that nobody can even believe. Is that correct . 35 a month from many times that number. The second rule were finalizing today will transform the way the u. S. Government pays for drugs, to end global freeloading on the backs of american citizens and american patients. Until now, americans have often been charged more than twice as much for the exact same drug as other medically advanced countries. We would be having a drug, identical drug, same company, and wed pay many times the price of what that drug would sell for in certain countries. In case after case, our citizens pay massively higher prices than other nations pay for the same exact pill, from the same factory, effectively subsidizing socialism abroad and skyrocketing prices at home. We would spend tremendous amounts of money in order to provide inexpensive drugs to another country. And when i say the price is different, you can see some examples where the price is beyond anything four times, five times different. For example, Medicare Part b recipients are forced to spend five times more for a common Breast Cancer medication than patients in other countries. So, five times more. And we have other examples that are substantially higher than that. To address this unfairness and to lower prices for americans, were finalizing the most favored nation rule. Remember that name. Most favored nation rule. Nobodys ever done this. The Drug Companies dont like me too much. But we had to do it. Took a long time before we were able to do this. Because statutorily, we had to go through a process. But there will never be anything like this. I just hope they keep it. I hope they have the courage to keep it. Because the powerful drug lobby, big pharma, is putting pressure on people like you wouldnt believe. Medicare will now look at the price that other developed nations pay for their drugs and instead of paying the highest price on the list, and we are substantially higher than any other country in the world, we will pay the lowest price. In other words, we take the lowest price and we match whatever the lowest price is. Leading to colossal savings for all americans. And were talking about savings of 50 , 60 , 70 , 80 , different drugs, different prices. In addition today, were taking one more historic action to hold down drug prices. In the past, Drug Companies have been allowed to identify certain very old generic drugs, that have been widely available for decades, and exploit a misguided program called unapproved Drugs Initiative. Thats unapproved Drugs Initiative, a program that has been around for a long time and hasnt been too good for the people that were supposed to benefit, to obtain Market Exclusivity on these medicines. So, we are doing something that nobody thought anybody would do. These savings is going to be incredible. Then theyve jacked up the prices by as much as 1,000 to 5,000 on this product. This program is also caused shortages of important medicines. Weay, im announcing that are ending the unapproved Drugs Initiative program to stop this unfair practice. So, prices are lifted by 1,000 to 5,000 in one or two cases even more than that. And were ending this. We are putting an end to it. Together, these reforms will save american patients many, many billions of dollars every single year. For generations, the American People have been abused by big pharma and their army of lawyers, lobbyists, and bought and paid for politicians. But ive been loyal to the special interests. Ive been loyal to our patients, people that need drugs, Prescription Drugs, and devoted myself to completely fighting for the American People. You see that. And this is not an easy thing to do. Big pharma ran millions of dollars of negative advertisements against me during the campaign, which i won, by the way, but, you know, well find that out. Almost 74 million votes, we had big pharma against us, we had the media against us. We had big tech against us. We had a lot of dishonesty against us. But big pharma alone ran millions and millions of dollars in ads. In fact, i looked at it, i said, who is it . They ive never seen anything quite like it because i told them, im going to have to do this. I was put here to do a job. And pfizer, and others, were way ahead on vaccines. You wouldnt have a vaccine if it werent for me for another four years because the f. D. A. Wouldve never been able to do what they did, what i forced them to do. And pfizer and others, even decided to not assess the results of their vaccine, in other words, not come out with a vaccine, until just after the election. Thats because of what i did with favored nations and these other elements. Instead of their original plan to assess the data in october, so they were going to come out in october, but they decided to delay it because of what im doing, which is fine with me, because, frankly, this is just a very big thing. A very big thing. What im doing here, i dont know if anyones going to appreciate it. These people cant even believe it. Alex, even you cant believe it, can you . Look at you. So, they waited and waited and waited, and they thought theyd come out with it a few days after the election. And it probably wouldve had an impact. Who knows . Maybe it wouldnt have. Im sure they wouldve found the ballots some place, the democrats. And the group. These corrupt games will not deter us from doing what is right for the American People and i will always put american patients first. And i think it can never be shown better than what im doing today already. Already, we have successfully lowered drug prices for the first time in 51 years. In september, we finalized a rule allowing states, wholesalers, and pharmacies to safely and legally import drugs from canada. Career politicians have promised to institute this reform for decades. But we got it done. The reason for canada, and this is going to be just, i think, a shortterm fix because until we have the favored nations fully ready, which we hope to be january 1, i think a very important thing, january 1, right around the corner, but im giving governors the right to go to canada because theyll pay approximately 50 less for their drugs that they buy for their states. So, the governors buying drugs for their states go to canada. They buy the drugs for very much less, and theyll be able to pass that on to the people of florida. Ron desantis was the first one to ask, but others are asking also. And its a great thing. I mean, your save 50 . Youll save 50 . Theyre going to buy a lot from canada, initially, and i think ultimately theyll be comparing prices. Youll get the lowest price anywhere in the world. So you wont need to buy from canada. In a few weeks, my administration will also finalize rules requiring federally funded Health Centers to pass drug company discounts on insulin and epipens directly to patients and the epipen prices come way down. We remember those horrible stories about epipens. Well, the price has now come way, way, way down. We capped insulin costs for many seniors at just 35 a month, as i said, saving them an average of nearly 500 to 1,000 a year. Just on insulin. Saving 1,000 a year on insulin. Since i took office, weve reduced Medicare Part d premiums by 12 , putting nearly 2 billion back into seniors pockets. Now 12 is great by any standard. But 12 is peanuts compared to what weve done with favored nations. I think its probably the biggest story that weve ever had, relative to drug prices. Theres never been anything like this. This is something that has been talked about for many years, but nobody had the courage to do it. Because of the power of big pharma. We ended the gag clauses that prevented pharmacists from telling patients how to buy less expensive drugs. As you know, pharmacists could not talk to patients about how to buy drugs. How about that one . Think thats right . Now they can and should. We approved a Record Number of affordable generic drugs for three years in a row and weve put a very heavy emphasis on generic drugs. And the pricing there has become very good. But that pricing will also go down very substantially. No administration has ever fought harder or achieved more for our patients and for our seniors. But for america, when you think of it, for america, because other countries were paying a fraction of what we were paying, in some cases a small fraction, i mean, it was the numbers were just staggering, the difference between going to i wont name nations, but i could name five of them right off the top of my head, that it is so incredible to think about, for years what was happening. Weve been working on this for two years. Statutorily, we had to go through a process. But when you think that our nation, for the exact same pill out of the exact same box, often made in the exact same factory, same company, and you take a look at the cost was so much more, many, many times more. In four short years, weve instituted the most dramatic series of drug pricing reforms in decades. And youll see that it all comes to fruition right now, starting january 1. And the American People will benefit from our actions for many, many decades. And it should be very immediate. Now, i presume theyll sue, but its a suit that they should never be able to win. They should never, ever be able to win. So now id like to ask secretary azar to provide some more details as to the action and then seema, id like you to come up and say a few words. Great job. We appreciate it. Thank you. [inaudible] sec. Azar well, thank you, mr. President. What an extremely exciting day for American Health care. On top of the news that you just made, today, pfizer will be filing an application for an emergency use authorization with the f. D. A. For their covid19 vaccine that appears to be 95 effective. Within weeks, we could have a decision from fda. And within 24 hours of that, we will have started distributing millions of doses of safe and effective vaccines to begin protecting our most vulnerable across america. You know, the president mentioned his passion for getting drug prices down and i can tell you, ive seen that firsthand. When i became secretary in january, 2018, the very first meeting we had in the oval office was to put together our plan for tackling drug prices. It was the number one priority , the president said, for us is getting drug prices down. In down. And in that meeting, we came up with the idea for most favored nation status. And for ensuring that the discount prices that big pharma was giving to middlemen would get passed on to americas seniors at the pharmacy counter. An almost two and a half years ago, in may, the president laid out the most comprehensive vision for reforming drug pricing in american history. The president s blueprint was clear. We need to put american patients first and our drug Pricing System too often puts them last. The system had to change. The blueprint called for tackling foreign freeriding, for bringing down high list prices, for reducing outofpocket costs , and for better negotiation by our government programs. Thats what the president has delivered over the last two years already. And thats what the president s delivering today with these new historic reforms. Were ending a broken system of shadowy kickbacks that drove Prices Higher and higher every single year, and left so many patients shocked at the outofpocket costs that they owe at the pharmacy. Were replacing that system with upfront discounts in medicare, delivered straight to the patient at the pharmacy counter. Were bringing negotiation to the way we pay for the most costly drugs in medicare, fixing a system where the government just took the price that Drug Companies offered, paying about twice as much as comparable countries. Were ending a program thats been used by Drug Companies to jack up prices on older drugs. The president s actions today boldly take on the big Drug Companies, take on the middlemen , and take on Foreign Countries free riding off of americans. If you dont believe how fiercely special interests have fought these efforts, you must not have watched any tv in washington over the last couple of years. Special interests have run millions of dollars in ads against the president s drug pricing initiatives. Mr. President , they underestimated me and they sure as the devil underestimated you. About two years ago, just over in the roosevelt room, the president signed legislation to ban pharmacy gag clauses. Alongside me and his drug pricing advisors. That included my friend and colleague, dan best, who passed away two years ago this month. And he devoted his life to lowering drug costs for american patients, putting them at the center of our Health Care System, just as President Trump has done. And he was one of the Key Driving Forces behind the rules that we are announcing today. I wish dan couldve been here today, mr. President , but todays actions are a Lasting Legacy for him and for you. The president s historic actions will transform drug pricing forever and build the system that the American People deserve, a system that puts american patients first. Thank you so much, mr. President , for making today possible. Pres. Trump thank you very much. Thank you. Seema masks and hoop earrings dont work well. Thank you, mr. President , for your leadership. And let me take a moment to give some context for todays announcement. From day one, President Trump made it very clear that he wanted to make health care more affordable and accessible to every american. And the most important thing is that he wasnt afraid to take on the special Interest Groups to get this goal accomplished. And in the absence of any meaningful legislative support , this administration has delivered real, tangible results. Premiums down in medicare by 34 , the lowest in 14 years. And some areas saw declines almost as much as 60 . We stabilized the exchange, lowering premiums for the first time, and brought back more plan choices. We have set forth a pathway to make the American Health care system work more efficiently to deliver better quality and lower costs, tackling longstanding problems that no other administration had the guts to do. And the list is long. Price transparency, so that patients know what theyre getting charged before they get their care, portable Digital Health records, so patients have their complete medical history right on their phone. Reducing regulatory burdens so that doctors can spend more time with patients. The Health Care System will work better because of what this administration and President Trump has accomplished. And as the president noted, our achievements on drug pricing are no less sweeping and unprecedented. Thanks to regulatory changes in 2017, premiums have dropped to some of the lowest rates in seven years, saving beneficiaries over 1. 9 billion in premiums. And were also bringing Price Transparency to medicare so that doctors and patients have pricing information when drugs are prescribed so that patients can get the best deal. The president s senior savings model has our Medicare Beneficiaries cheering this year as they are selecting plans in this years open enrollment. They have over 1600 plans that are offering insulin for just 35 a month or less. And that is a massive 66 savings. Todays announcement is about part b, where the Medicare Program has been nothing but a powerless price taker. And the problem is similar. While there are Market Forces and negotiations that serve to reduce costs in other part of the Health Care System, it just doesnt exist in part b, which pays for drugs that you get in a doctors office, cancer drugs, and other infusions. In part b, american seniors and taxpayers pay whatever Drug Companies want to charge. And doctors also get paid a percentage addon, so the higher the drug cost, the more they get paid, giving an overt incentive to prescribe higherpriced drugs, and for manufacturers to increase those prices. So, its no wonder that american seniors are paying twice as much as what other countries are paying. And because of this, over the past five years, medicare spending for part b drugs has gone up by 55 on average, and drug spending in part b is responsible for over a third of the premiums that our seniors pay. So the bottom line is, higher drug costs lead to higher premiums and higher copays. Doctors do well, Drug Companies do well. The patients pay more. This effort is going to save over 85 billion over seven years, and saving seniors over 28 billion, as well. And so i want to thank the president for being a problem solver, for willing to think big and to act boldly on behalf of the american patients. His record of success over the last four years is a testimony to that mentality. Thank you. Pres. Trump thank you. [indiscernible] with coronavirus cases increasing across the country, use our website, cspan. Org coronavirus to follow the trends, track the spread with interactive maps, and watch updates on demand, anytime, at cspan. Org coronavirus. New York Democratic representative alexandria ocasiocortez spoke on the floor about the ongoing coronavirus pandemic, and efforts to divide further relief. In her remarks, she blamed the senate. Here are her comments. Ms. Ocasiocortez i ask unanimous consent that all members have five legislative days to extend

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